Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Feb;20(1):43-9.
doi: 10.1179/2042618611Y.0000000017.

Effectiveness of mechanical diagnosis and therapy in patients with back pain who meet a clinical prediction rule for spinal manipulation

Ron Schenk  1 , Carol Dionne, Corey Simon, Robert Johnson
Affiliations

Effectiveness of mechanical diagnosis and therapy in patients with back pain who meet a clinical prediction rule for spinal manipulation

Ron Schenk et al. J Man Manip Ther. 2012 Feb.

Abstract

Recently a clinical prediction rule (CPR) for lumbar regional spinal thrust manipulation (STM) has shown predictive success in patients with back pain who met specific selection criteria. The purpose of this study was to compare the effectiveness of STM and mechanical diagnosis and therapy (MDT) in patients who are positive for the STM CPR. Following initial examination, 31 participants were randomized to the STM group (n = 16) and to the MDT group (n = 15). Two weeks following initial examination, four participants chose to cross over from the STM group to the MDT group. The Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire work subscale (FABQw), and the Numerical Pain Rating Scale (NPRS) were administered initially, and at 2-weeks and 4 week follow-up (discharge). Data were analyzed to determine changes in ODI and NPRS scores from initial examination through one month. Of the 31 participants, one patient who met only three of five selection criteria and four others who chose to switch groups were removed from the analysis. Both groups exhibited statistically significant improvements in ODI and NPRS scores from baseline to final visit but there was no significant difference in scores between groups at 4 weeks. In this sample of patients, the selection criteria for this CPR were not exclusive for lumbopelvic STM. Mechanical diagnosis and therapy was an equally viable choice for these patients.

Keywords: Clinical prediction rule; Low back pain; Mechanical diagnosis and therapy; Spinal manipulation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CONSORT Flow Diagram
See this image and copyright information in PMC

References

    1. Miller E, Schenk R, Karnes J, Rousselle J. A comparison of the McKenzie Approach to a specific spine stabilization program for chronic low back pain. J Man Manip Ther 2005;13:103–12
    1. Allen RJ. Physical agents used in the management of chronic pain by physical therapists. Phys Med Rehabil Clin N Am 2006;17:315–45 - PubMed
    1. Kohlbeck FJ, Haldeman S, Hurwitz EL, Dagenais S. Supplemental care with medication assisted manipulation versus spinal manipulation therapy alone for patients with chronic low back pain. J Manipulative Physiol Ther 2005;28:245–52 - PubMed
    1. Lisa AJ, Holmes EJ, Ammendolia C. High-velocity low-amplitude spinal manipulation for symptomatic lumbar disc disease: a systematic review of literature. J Manipulative Physiol Ther 2005;28:429–42 - PubMed
    1. McGill SM. Low back stability: from formal description to issues for performance and rehabiliation. Exer Sport Sci Rev 2001;29:26–31 - PubMed

LinkOut - more resources